Basic Information
| Provider Information | |||||||||
| NPI: | 1780056846 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REAL BIRD | ||||||||
| FirstName: | NATALIE | ||||||||
| MiddleName: | KIM | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 13TH ST W | ||||||||
| Address2: | |||||||||
| City: | HARDIN | ||||||||
| State: | MT | ||||||||
| PostalCode: | 590342400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066657023 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 W 4TH STREET SUITE B | ||||||||
| Address2: | BIG HORN VALLEY HEALTH CENTER | ||||||||
| City: | HARDIN | ||||||||
| State: | MT | ||||||||
| PostalCode: | 590341804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066654103 | ||||||||
| FaxNumber: | 4068674103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2015 | ||||||||
| LastUpdateDate: | 10/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 978 | MT | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.